Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA.
Division of Nephrology, Seattle Children's Hospital, 4800 Sand Point Way NE, M/S OC.9.820, Seattle, WA, USA.
Curr Hypertens Rep. 2019 Apr 5;21(5):35. doi: 10.1007/s11906-019-0943-x.
To evaluate the impact of the 2017 American Academy of Pediatrics Clinical Practice Guideline (2017 AAP CPG) for Screening and Management of High Blood Pressure in Children and Adolescents.
The 2017 AAP CPG had several significant changes compared to the 2004 Fourth Report. This review will focus on the emerging evidence from the first studies to apply the 2017 AAP CPG and the simplified table it contains on the overall prevalence of HTN and on recognition among children and adolescents at a higher cardiovascular risk. Recent evidence suggests that use of the 2017 AAP CPG will result in an overall increase in prevalence of HTN, particularly in youth who are obese or who have other cardiovascular risk factors. The change in prevalence likely differs based on sex, age, and height. The ability for the 2017 AAP CPG to detect an association with hypertension and target organ damage requires further study. Continued study is required to assess long-term implications of the 2017 AAP CPG with the goal of a more meaningful HTN definition in the young.
评估 2017 年美国儿科学会临床实践指南(2017 年 AAP CPG)对儿童和青少年高血压筛查和管理的影响。
与 2004 年第四版报告相比,2017 年 AAP CPG 有几个重大变化。本综述将重点关注首次应用 2017 年 AAP CPG 及其包含的简化表格的研究中的新证据,这些研究涉及 HTN 的总体患病率以及在心血管风险较高的儿童和青少年中的识别率。最近的证据表明,使用 2017 年 AAP CPG 将导致 HTN 的总体患病率增加,特别是在肥胖或有其他心血管危险因素的年轻人中。患病率的变化可能因性别、年龄和身高而异。2017 年 AAP CPG 检测与高血压和靶器官损伤之间关联的能力需要进一步研究。需要进一步研究以评估 2017 年 AAP CPG 的长期影响,以期为年轻人制定更有意义的高血压定义。